A 52-year-old female, presented to the primary care provider with complaints of weakness and fatigue, although she continued to work. She attributed these changes to menopause; her menstrual periods have been irregular but occasionally heavy.
She experienced recent weight loss of 10 lbs over the past 6 months not attributable to diet or exercise. LABORATORY FINDINGS Initial laboratory workup showed: White blood cell count: 5200 cells/mm3 Hemoglobin (Hb): 7.5 g/dl Hematocrit: 26% Red blood cell (RBC) count: 3.5 x 106/µl Platelet count: 650 000/µl Mean corpuscular Hb: 24.8 pg/cell Mean corpuscular Hb concentration: 33.4 g/dl Mean corpuscular volume (MCV): 55 µm3 Reticulocyte count: 1.5% Serum chemistries were: Creatinine: 1.1 mg/dl Bilirubin (total): 0.9 µmol/dl Blood urea nitrogen: 15 mg/dl Glucose: 124 mg/dl Sodium: 134 mEq/L Potassium: 4 mEq/L Magnesium: 1.8 mEq/L Calcium (total): 9.2…
